Sonographic Study of Scar Thickness in Post-Cesarean Pregnancy and Its Obstetrical Outcome

Abstract

Background: The rising incidence of caesarean deliveries has increased the need to assess scar integrity during subsequent labours. Ultrasonographic evaluation of lower uterine segment (LUS) thickness provides a non-invasive tool for predicting scar outcomes.

Objectives: To assess LUS scar thickness by ultrasonography in labouring post-caesarean women and correlate it with maternal and neonatal outcomes.

Methods: A prospective observational study was conducted on 110 term pregnant women with previous caesarean sections who presented with lower abdomen, at SRMS Institute of Medical Sciences, Bareilly, over a period of 1 ½ years from May 1, 2023, to October 31, 2024. Transabdominal sonography was used to measure LUS thickness, and obstetrical outcomes were compared across the three groups based on the number of prior caesareans, i.e., previous 1 LSCS (Group A), previous 2 LSCS (Group B), previous 3 LSCS (Group C). Intra-operative findings, maternal recovery, and neonatal health were recorded.

Results: Scar thickness ≤2.5 mm was significantly associated with higher rates of scar dehiscence, rupture, postpartum haemorrhage, delayed recovery, and adverse neonatal outcomes such as NICU admission and respiratory distress (p < 0.05).

Conclusion: Sonographic LUS thickness is a reliable predictor of obstetrical outcomes and can aid clinical decision-making in post-caesarean term pregnant women, presenting with pain lower abdomen